Pressure Check

By Christine Gorman

For the past 25 years, doctors in the U.S. have warned their patients about the dangers of high blood pressure, a generally symptomless condition that increases the risk of heart disease, kidney failure and stroke. By aggressively treating folks whose readings exceed the normal limit of 140/90 mm Hg at rest, physicians have prevented millions of premature deaths and untold suffering. But it looks as if we've stopped getting the message. A national health survey released two years ago showed that blood-pressure rates are no longer falling; at the same time, the incidence of stroke has started to rise.

The biggest increases have been among black, Hispanic and poor Americans. But they're not alone. A report in the September issue of Hypertension, which was published last week, shows that blood-pressure readings among the largely white residents of affluent neighborhoods in Minnesota are 5% higher than they were just 10 years ago. And as those figures have risen, the number of people with hypertension who are aware of their condition has fallen.

There are probably several reasons that blood-pressure rates are going up and awareness is going down. An ironic possibility is that we've spent so much time obsessing about cholesterol levels that we've forgotten about blood pressure. That's kind of like throwing baking soda on a grease fire in the kitchen but forgetting to turn off the burner. Under normal circumstances, blood vessels in your body will last about 100 years. The extra wear and tear from high blood pressure makes them brittle before their time. Then cholesterol deposits start to build up over the damaged sections, restricting blood flow even more. The bottom line: high blood pressure can be every bit as lethal as high cholesterol.

Many men and women with high blood pressure require one or more prescription drugs to get it under control. If you experience an unpleasant side effect, like mild depression, don't suffer in silence. There are dozens of different blood-pressure medications. Ask your doctor about switching to another drug.

Eating right and getting plenty of exercise can decrease your need for medication or even eliminate it. In 1997 a study called Dietary Approaches to Stopping Hypertension showed for the first time that a diet rich in fruits and vegetables, includes low-fat dairy products and keeps the lid on saturated fat can lower blood pressure dramatically. It might take you a while to get used to eating the required eight to 10 servings of fruits and vegetables a day, which is twice what most Americans consume, but your efforts are likely to be rewarded. Among members of the multiethnic study group, diastolic pressure (the bottom number) dropped an average of 6%.

If you're overweight, you'll need to slim down--even 10 lbs. can make a difference. And be sure to avoid over-the-counter cold remedies like Sudafed and Actifed as well as herbal preparations like St. John's wort and ginseng, which can boost your blood pressure. Of course, none of these lifestyle changes are substitutes for having your blood pressure regularly checked and getting it treated if necessary. As always, staying healthy means keeping track of lots of things--and being willing to turn to your doctor for a little help.

For more information, visit www.ameri canheart.org or dash.bwh.harvard.edu You can e-mail Christine at gorman@time.com